What exactly is the natural history of low back pain? Some people would say, just let back pain go as it will improve by itself through the passage of time. But, is this really the case?
90: The percentage of patients who get better on their own by 6 weeks (70% by 4 weeks). This is what we have heard and go by. However, how true is this? The data from this comes from a long time ago (1966) and comes from patients NOT returning to primary care providers for back pain. The researchers figured out that since this percentage of individuals did not return…then their pain abolished. Source here.
21: The percentage of patients who actually recover by 12 weeks (notice double the time?). This may actually be the true number. Reason being, the individuals with back pain just did not return to their primary care providers because honestly, they weren’t doing anything for them! The care-seeking data from the previous number is altered. Source here.
So, what does this mean? It means we don’t necessarily need to sit back and let LBP go through its course. You, as physical therapists, can assist with this. Just look at the recent data from Direct Access and one of variables associated with improvement from manipulation for CPR (less than 16 days).
Don’t let acute pain lead to chronic pain. Educate your patients (and then their families).